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	<div data-role="header">
    	<a href="index.html" data-icon="home" data-transition="pop" data-theme="b" >Home</a>
    		<h1>Projet Tisseo</h1>
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    <div data-role="content">
    <div class="ui-grid-solo ui-responsive">
    
    	<form method=post action="mailto:tisseo.webappli@gmail.com" enctype="application/x-www-form-urlencoded" id="form">
   			<h3>Vous</h3>
   				<div data-role="fieldcontain " class="ui-field-contain ui-body ui-br">
      				<label for="id_name">Votre nom&nbsp;:</label>
      					<input type="text" name="nom" id="id_nom" value="" required="required" data-mini="true" />
   				</div>
   				
   				<div data-role="fieldcontain">
      				<label for="id_name">Votre prénom&nbsp;:</label>
      					<input type="text" name="prenom" id="id_prenom" value="" required="required" data-mini="true" />
   				</div>
   			<h3>L'application</h3>
   				<div data-role="fieldcontain">
      				<label for="id_note">Si vous deviez noter cette application ?&nbsp;</label>
      					<input type="range" name="note" id="id_note" value="5" min="0" max="10" data-highlight="true" data-mini="true" />
    			</div>
    
   				<div data-role="fieldcontain">
				      <label for="id_recom">Recommanderiez-vous cette application ?&nbsp;</label>
				     	 <select name="recom" id="id_recom" data-role="slider" data-mini="true">
				      		<option value="Non">Non</option>
				     		 <option value="Oui">Oui</option>
			      		</select>
			   </div>
 
			   <div data-role="fieldcontain">
			      <label for="id_commentaire">D'autres remarques concernant l'application ?&nbsp;</label>
			      	<textarea name="commentaire" id="id_commentaire" data-mini="true"></textarea>
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			      <div class="ui-block-b"><button type="submit" data-mini="true" data-inline="true" data-theme="b">Envoyer</button></div>
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